PhD Scientific Days 2023

Clinical Medicine - Posters I

Obesity’s impact on short and long-term outcomes after cardiac resynchronization therapy

Előadó neve

Dr. Merkel, Eperke

Neptun code

E85DK3

Előadó munkahelye

Semmelweis University, Heart and Vascular Center

Előadó telefonszáma

06704087217

Előadó e-mail címe

merkel.eperke@gmail.com

Az előadás címe

Obesity’s impact on short and long-term outcomes after cardiac resynchronization therapy

Szerző(k) neve és munkahelye

Heart and Vascular Center, Semmelweis University

Bemutatás módja

Poszter

Szekció

Clinical Medicine - Posters I

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Introduction: Obese patients have a higher risk for heart failure (HF), however, a subset of them may have a more favorable outcome, known as the obesity paradox.
Aims: We sought to assess the association of body mass index on all-cause mortality in candidates for cardiac resynchronization therapy (CRT).
Methods: We studied retrospectively 1585 patients undergoing CRT implantation at our clinic between 2000-2020. Patients were categorized into three groups: normal weight (BMI ‹25 kg/m2) overweight (BMI 25-‹30 kg/m2) and obese (BMI ≥30 kg/m2). The composite primary endpoint was all-cause mortality, heart transplantation or implantation of a left ventricular assist device. Survival was studied by log-rank and Cox regression analysis. Our secondary and tertiary endpoints were the rate of periprocedural complications and echocardiographic response.
Results: During the follow-up time, 973 (61%) reached our primary endpoint, 302 (66%) in the BMI ‹25 kg/m2 group, 389 (61%) in the BMI 25-‹30 kg/m2 group and 282 (58%) in the BMI ≥30 kg/m2 group (p‹0.05). Obese patients showed mortality benefit over normal-weighed patients (HR 0.78; 95%CI 0.66-0.92; p=0.003). Patients with a BMI ‹25 kg/m2 showed a 19% higher risk of all-cause mortality than overweight and obese patients (HR 1.19; 95%CI 1.03-1.38; p=0.02) at multivariate analysis. The obesity paradox was not present in patients with diabetes (HR 0.85; 95% CI 0.66-1.10; p= 0.20), with atrial fibrillation (HR 0.89; 95% CI 0.77-1.11; p=0.30), in patients of ischemic etiology (HR 0.94; 95% CI 0.78-1.13; p=0.51) and in the elderly (HR 1.01; 95% CI 0.86-1.20; p=0.86).
Periprocedural complication rates did not differ in the three groups. In all patient groups, a significant improvement in LVEF at 6 months can be observed (p<0.001). No difference was seen in the proportion of developing reverse remodeling (p=0.75).
Conclusion: The obesity paradox was present in our CRT patient cohort, however, mainly patients free of comorbidities showed survival benefit with obesity. Periprocedural complications did not occur more frequently in obese or overweight patients. The echocardiographic response did not vary across the patient groups.
Funding: Project no. RRF-2.3.1-21-2022-00003 has been implemented with the support provided by the European Union.

University and Doctoral School

Semmelweis University, Doctoral School of Theoretical and Translational Medicine

Supervisor

Dr. Annamária Kosztin

Publication of my abstract

I give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

4650

Start

11:30

End

11:35

Authors (legacy)

Heart and Vascular Center, Semmelweis University